If your office staff lacks good
business knowledge, teach them about
it.

The
lessons you learned in part 1 of this series
introduced you to many of my medical practice
eroding mistakes, not so different from hundreds
of other physicians starting their practice, yet going
well beyond good judgment that you might relate to
in some way.

For physicians who are never taught, never
learned, never considered the importance of knowing
how to effectively manage the business of their
medical practice, which is basically all physicians
who graduate from medical school, even today, it's a
matter of learning it all the hard way and having to
suffer along the way more than
you need to.

We
normally consider ourselves as being quite
intelligent, as being above average in common sense
and judgment, and as being intellectually selective in
understanding the academic steps necessary for a
medical career to succeed.

If we are in that elite
group of academically enlightened individuals, then,
why is it that you are easily convinced that the
illustrious practice of medicine can easily be
successful without a knowledge of managing a small
business effectively and without implementing the
proven elements applicable to all successful
businesses?

Now, to
dig much deeper into the reasons why all of us are
caught in the web of medical tradition, miss out on
the true business foundations, and near the end
of our practice years are forced to realize we could
have done much more with
our medical practice.

We
could have been more business oriented, been a better
manager, earned a lot more money, spent more time with
our family, and used our intensive medical education
to accomplish a much higher degree of personal
accomplishment over those years. These regrets are ever present in older docs, but too late to make
amends. Not going to happen to you... right?

Medical practice business mistakes
and solutions

1.
Believing that your position in medicine will
miraculously launch you over any financial barriers
you face (tradition)

Talk to
any successful entrepreneur in business today
and they will tell you that
one of the best ways to
rise to the top is using a leap frog financial
strategy. When you open your first office, spend as
little as possible, either by renting space in a
reasonable location, or sharing office space with
another physician until you have discretionary income
enough to move, renovate,
and go solo.

A common
way to cut costs and save money is to join an existing
medical practice with a formal cost sharing agreement
on paper. Those physicians who start out as
an HMO
employee and later decide to go into private practice
rarely save enough money to carry them into and
through the first 6 months in a new practice. Face it!
We have felt money deprivation for so many years by
then that the first natural
urge when you finally are
earning some money is to spend it for
"soul"
satisfaction.

One of
the reasons for holding off on buying a new car or
house or signing a long term lease agreement for your
office, at least for the first 3 years is related to
your practice future. Presently, about 10 to 12% of
doctors move their practice each year according to an
AMA survey. They must have a good reason to do that.
Right?

The two
most common reasons for any physician to move their
medical practice elsewhere arefinancial and
financial.
The first is a direct result of practice competition
where a physician is unable to draw a sufficient flow
of patients to financially sustain his or her practice
business.

The second is a little more subtle, goes
unrecognized long before the crisis happens, and
occurs at a time when sensibly it shouldn't be
happening. It's a time when the chaos of your own
unorganized and reactive management of your
practice business reaches a point (usually 5 to 10
years into your practice) where your business
instability can no longer be depended on for growth or
financial independence of
your practice. You should
understand the underlying cause, but most physicians
never see it.

You'll
notice that each of these financial disasters are
those which could easily be resolved by knowing how to
effectively run your practice business using business strategies that are employed in all
successful businesses. You don't have to move your
practice... just your mindset.

Often,
this is also a time when you look back to the time
when you were deciding where to start your medical
practice. Where do I want to live for the next 30 or
so years? Am I obligated to go back to my own home
town because of family ties? Is it the climate that
makes the most difference to you? Shall I go to a big
city with lots
of potential patients available?

If you
are business literate, no matter what the emotional
influences are, there are critical business related
demographics that make a world of difference to your
success or failure. For example, if you were an ObGyn
physician looking for a place
to practice, you should
know the basic statistical data concerning your
probability
for practice success before you decide on
the town or city or state.

When you divide the number
of OBG physicians practicing in the city into the
population of the area and discover that the ratio is
more than one ObGyn
physician per 10,000 population
you'll probably not succeed there without
a
vicious struggle
for patients.

Finding
the ratio to be 1/20,000 population or more, would
indicate you most likely will be able to start a
practice there, build it rather fast, and hold a
strong position
for your practice business in the
area.

Successful physicians are those who have checked their
competition, visited the area where they want to start
practice, matched the amenities to their family needs,
researched the available consultants they will rely
on, know the hospital facilities in detail, and have
an exact mental picture of where they want to be 20 or
30 years in the future with their practice.

Medical
students would be significantly far ahead to begin
selecting an area to practice in long before they
finish medical school. Most students are so busy
learning they see no reason to do a little forward
thinking, at least those who haven't already made
arrangements to join another physician already in
practice, or selected a non-patient related field like
research. Young doctors often just move into an area
they like and hope for the best... a mistake they often
regret for years after.

Preparation for medical practice involves much more
than medical knowledge! A fantastic physician in
a lousy practice, or practice area, will result in
disappointment carefully rationalized to the point of,
"It's good enough." Is it?

2.
Believing that your medical practice business will be
successful enough simply by using your own mental
accumulation of business experiences you've read and
heard about

Businesses fail when the business owner fails in one
or more of the three requirements for having
employees: Leadership,
Management, Supervision.

If you
insist on having employees, it shackles you with
responsibility. There are things you simply have to do
almost continuously to keep them from stealing you
blind, force them to work to your specifications, and
reward those who do... firing those
who don't.

The
employer and employee relationship is inherently adversarial. Your personal agenda for the business
interferes directly with their agenda. When you impose
your agenda, you disrupt theirs.

Facts and reality about your
medical
business

Employees do
not own your business. You do.

Your
business is your career and life and your life is
your business.

Employee
agendas are saturated with unavoidable
resentment that
arise from disparities in wealth
and power (that's
you).

Employees are not your friends.

Employees are not your family.

You are
not there to make your employees happy.
They forget you are there to pay them for work,
and to generate
profits.

Every
single employee, irrespective of how much you
pay
them, how well you treat them, or how valuable
to the
practice they are, will leave your business
sometime
and will need to be replaced.

It's
necessary at least twice a day to whack
yourself beside the head to remind yourself about the
true reality of running a business, that is, if you
care anything about having a highly greased profitable
business machine that you control. If you are
considered to be a pain in the ass,
that's perfect.

When
someone asks you what kind of employee you want, tell
them a "profitable employee."The only
credible reason to have an employee is for profit.
Don't pile
up a group of employees around you for
irrational reasons. Business requires an
ROI from each
employee. Your job as CEO and owner is to maximum
company income and business value.

Keep in
mind it's not your responsibility to provide
Jane with a job, nor is it your responsibility to pay
her enough to support herself or her family, or out of
work husband who can't find a job. It's Jane's
responsibility to make herself such a
valuable
employee you can't run your business without her. It's
her job, if not satisfied, to find a better paying
job.

Job
duties and responsibilities must be clearly
communicated, repeated often, and taught. That's your
management job. Office managers don't have the future
view
you have for the direction and goals you have for
your business, nor what you envision as needed for
what each employee must do to help
you complete
your
mission.

If you told your office manager all those
details, do you think the manager would remember them
all, or even be capable enough to take your place in
this process?

Make an
extreme effort to...

1. Replace any employee who doesn't pull their
load daily.

2. Avoid hiring older experienced people who will
constantly be
doing things they have learned... not
what you want done.

3. Avoid being too friendly with employees because they
will
automatically manipulate you as
a result.

4. Avoid automatic bonuses and rewards for certain jobs,
holidays, birthdays, because they will then always
expect
them in the future.

5. Reward those who go well beyond what is expected of
them,
but only do it as a surprise
to them.

6. Hire employees
slowly... and fire them
fast.

Studies
have shown that the average firing occurs about 6 to
18 months after the business owner knew that the
employee was consistently performing poorly, was
routinely non-compliant, and was poisoning the rest of
the staff.

Should
you decide to be the kind old gentleman doctor
who is loved and admired by his office staff because
you are forgiving, benevolent, and leave them alone,
then
you should understand that the
practice profits lost
in doing so compromises your lifestyle, your
maximum practice potential, your family needs, and
your ability to have the income necessary to learn new
skills, upgrade your medical knowledge,
and improve
your value to
your patients.

And that, my friend, is
a no B.S. life principle that eventually will track
you down
and destroy
your dream.

Article #9A

ARTICLE---DAN
KENNEDY

Why People Fail

A series
of No B.S. Articles from Dan Kennedy

"Now Is The Time To
Do It Differently"

“Help! – I Can’t Get Out Of The Box I Put Myself In!”

The fast food industry got the idea for drive-in
windows from banks. I guess there was a
McDonalds executive sitting at the bank drive-through
one day who thought, “I don’t think we can fit the
milkshakes in these tubes, but…” Netjets, the
leader in fractional jet ownership, now owned by
Warren Buffet, owes its birth to the vacation
time-share industry.

The microwave in your kitchen was
not originally intended to go there; its original
manufacturer, Litton, believed no consumer would buy
it and built them only for restaurants. When was the
last time you heard of Litton? What does this tell
you? That successful businesses live or die by
cross-industry ‘borrowing’ of ideas, that inspiration
more often comes from outside the box than from
within.

Ordinary businesses stay ordinary, their
owners eking out only ordinary incomes – and working
too hard for them – as long as those owners foolishly
and stubbornly, mentally stay in their
own tiny
backyard.

Breakthroughs come from bringing fresh ideas
found outside one’s own business in and applying them
in new ways. You choose to limit or expand
your income by the way you reject or embrace ideas
found far afield from your present modus operandi and
industry norms.

The vast majority of ordinary businesspeople with
ordinary incomes and never-ending ordinary complaints
about how hard they work but how little they gain,
about being unable to compete with the bigger and
cheaper…have this in common: they get their hands on
powerful information like that in this very
publication and waste their time and energy in the non-creative activity of finding all the ways it
can’t and
doesn’t
apply to them.

Some
people have such teeny, tiny, calcified, crippled
imaginations they can only appreciate an example
precisely matched to them – oh, that won’t work for
me because her place sells pizza and I sell Chinese
food, and hers is in a medium sized city and I’m in a
small town, and it rains a lot where she is but it’s
sunny here; you have to show me an example from a
Chinese restaurant in a small town where it’s hot and
dry. Fools stay stuck in the very limiting “But My
Business Is Different” box, thereby negating the value
of 99% of every successful strategy, example, model
they see or are presented with.

My client list is, fortunately, chock full of people
who think in very opposite ways. They get rich by
finding the non-obvious opportunities. Living
creatively. Adapting tried-and-true winning strategies
from somewhere else to where they are. They attack
each issue of my newsletter, each book I suggest to
them, with yellow hi-liter and bias for action, not
closed mind.

They are willing, even eager to
“re-imagine” their businesses while others have Bilbo
Baggins’ (The Hobbit) attitude: not interested in adventures – they make you late for dinner. Space
here does not permit telling you such client stories,
but I’d invite you to get a peek, viewing the
half-hour TV show at
www.In12Months.com, free of charge.

One of the most successful marketing strategies of
all time is called ‘gift with appointment.’ Today, it
brings new patients into dentists’ offices, affluent
investors to financial advisors’ seminars, new home
buyers to developments and resort communities, and is
in play in hundreds of fields, helping to create
millions of sales appointments every week.

To the best
of my knowledge, it came from a woman named Estee
Lauder. I wonder how many people from how many
different fields ignored it for how long, because:
“Nothing having to do with selling lipsticks and
perfumes could possibly apply to MY business. MY
business
is
different.The WHY PEOPLE FAIL articles are provided by Dan S.
Kennedy, serial entrepreneur, from-scratch
multi-millionaire, speaker, consultant, coach, author
of 13 books including the No B.S. series (www.NoBSBooks.com),
and editor of The No B.S. Marketing Letter. WE HAVE
ARRANGED A SPECIAL FREE GIFT FROM DAN FOR YOU
including a 2-Month Free Membership in
Glazer-Kennedy Insider’s Circle,
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